Saranyan Shared "Reproductive" - 21 Picmonics
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Reproductive
Mullerian Agenesis/Aplasia
- Congenital Absence of Uterus & Upper Vagina
- Primary Amenorrhea
- Nml. 2/2 Sex characteristics, Karyotype, Estrogen, Testosterone
- Renal U/S for GUT Anomalies e.g. U/L Renal Agenesis
- Tx: Surgery
Klinefelter's Syndrome
- Pathophysiology
- Male (XXY)
- Signs and Symptoms
- Eunuchoid Body Shape
- Gynecomastia and Female Hair Distribution
- Testicular Atrophy
- Dysgenesis of Seminiferous Tubules
- Possible Developmental Delay
- Hypogonadism
- Decreased Inhibin B
- Increased FSH
- Abnormal Leydig Cell Function
- Decreased Testosterone
- Increased LH
- Increased Estrogen
- Barr body (inactivated X chromosome)
6 mins
Turner Syndrome
- Signs and Symptoms
- Female (XO)
- Short stature
- Shield Chest
- Cystic Hygroma (Webbing of Neck)
- Lymphedema in Hands and Feet
- Ovarian Dysgenesis
- Streak Ovary
- Decreased Estrogen
- Increased FSH
- Increased LH
- Dysgerminoma
- Bicuspid Aortic Valve
- Preductal Coarctation of the Aorta
- Horseshoe Kidney
- Menopause before Menarche
- Amenorrhea
5 mins
Double Y Syndrome (47, XYY)
- Paternal Nondisjunction (Anaphase II)
- Phenotypically Male
- Tall Stature
- Severe Acne
- Nml. Fertility
Placental aromatase deficiency
- Placental aromatase deficiency
- Inability to synthesize estrogens from androgens
- Masculinization of female (46,XX) infants
- Ambiguous genitalia
- Increased serum testosterone and androstenedione
- Can present with maternal virilization during pregnancy (fetal androgens cross the placenta)
Androgen Insensitivity (Complete)
- Defect in Androgen Receptor
- Phenotypically Female
- (46, XY)
- Female External Genitalia
- Rudimentary Vagina
- Scant Sexual Hair
- Testes Often in Labia Majora
- Testes Surgically Removed to Prevent Malignancy
- Increased Estrogen, Testosterone, and LH
- Absent Uterus and Fallopian Tubes
3 mins
5 Alpha Reductase Deficiency
- Autosomal Recessive
- Inability to Convert Testosterone to DHT
- Normal Internal Genitalia
- Ambiguous External Genitalia until Puberty
- Masculinization During Puberty with Growth of External Genitalia
- LH can be Increased
- Normal Estrogen, LH, and Testosterone levels
2 mins
Kallman Syndrome
- Mutation in KAL-1 or FGFR-1 Gene
- Failure of GnRH Secreting Neurons
- Delayed Puberty
- Anosmia
- Hypogonadism
- Infertility
2 mins
Leuprolide
- Mechanism
- GnRH Agonist (Pulsatile Use)
- GnRH Antagonist (Continuous Use)
- Upregulates FSH And LH
- Downregulates FSH And LH
- Indications Pulsatile
- Infertility
- Indications Continuous
- Prostate Cancer
- Precocious Puberty
- Uterine Fibroids
- Endometriosis
- Side Effects
- Anti-androgenic Effects
2 mins
Estrogen Drugs
- Estrogens
- Estrogens: Estradiol, DES, Mestranol
- Estrogen Receptor Agonists
- Hypogonadism or Ovarian Failure
- Postmenopausal Women
- Androgen-Dependent Prostate Cancer
- Side Effects
- Thromboembolism
- Breast Cancer
- Increased risk of endometrial cancer
- DES: Clear Cell Adenocarcinoma of Vagina with exposure in utero
- P450 Reduces Efficacy
Clomiphene
- Clomiphene Citrate
- Infertility
- PCOS
- Estrogen Antagonist at hypothalamus
- estrogen antagonist
- Hypothalamus
- Side Effects
- Hot Flashes
- Visual Disturbances
- Multiple Gestations
- Ovarian Torsion
Aromatase Inhibitors
- Indications
- Estrogen Receptor-positive (ER+) Breast Tumors
- Systemic Metastases
- Drugs
- Reversible, non-steroid
- Letrozole
- Anastrozole
- Irreversible, steroid
- Exemestane
- Side Effects
- Osteoporosis
- Arthritis
1 min
Progestin and ANTI-Progestins
- Progestins
- Use: Oral Contracepton, Menopause, Uterine Bleeding, Amenorrhea/Dysmenorrhea, Postpartum Lactation Suppression
- Progesterone (Progestins)
- Medroxyprogesterone
- Megastrol
- Norethindrone
- Depo-Provera Injection (DMPA)
- Progestin ONLY
- Causes ↓ Bone density, Weight gain, Mood changes
- Fx: Bone Density Reduction
- Megastrol: Breast Cancer
- Anorexia in AIDS
- ANTI-PROGESTINS
- Mifepristone (RU-486)
- Competetive Progesterone Receptor ANTAGONIST
- Use: Hyperglycemia from Cushing Syndrome
- Fx: Miscarriage, Vaginal Bleeding, Abd. Pain/Nausea
- Ulipristal
- Antiproliferative effect in Uterus, Blocks Ovulation (Blocks LH)
- Emergency Contraception (5 Days)
- Fx: Headache, Early Menstruation, Nausea
Mifepristone (RU 486)
- Prosgesterone receptor antagonist
- Induce myometrium contraction
- Medical Abortion
- Nausea and Vomiting
- Diarrhea
- Abdominal pain
- Bacterial infections
- Excessive bleeding
Contraception
- Indications
- Preventing Unplanned Pregnancy
- Barrier Methods
- Spermicides
- Diaphragm
- Cervical Cap
- Contraceptive Sponge
- Male Condom
- Hormonal Method
- Oral Contraceptive
- Intrauterine Device (IUD)
- Injectable Progestins
2 mins
Combination Oral Contraceptives
- Monophasic
- Biphasic
- Triphasic
- Smoking
- MOA
Danazol
- Inhibit anterior pituitary
- Decrease FSH and LH
- Endometrial atrophy
- Endometriosis
- Fibrocystic breast disease
- Weight gain
- Acne and hair growth
- Thromboembolism
- Hepatic effects
- Intracranial hypertension
Testosterone
- Testosterone Aqueous
- Testosterone Cypionate
- Testosterone Gel
- Fluoxymesterone
- Therapuetic Use
- Hypogonadism
- Anabolic effects
- Growth
- Adverse effects
- Females
- Males
- Adverse Effects
Androgen Antagonists
- Finasteride
- 5-Alpha Reductase Type II Inhibitor
- indicated for BPH, Alopecia
- Flutamide
- Non-steroidal Competitive AR Antagonist
- indicated for Metastatic Prostate CA
- give with Leuprolide
- SFx: Teratogen
- Ketoconazole
- Spironolactone
Minoxidil (Loniten, Rogaine)
- Mechanism
- Vasodilates Arterioles
- Indications
- Severe Hypertension
- Baldness
- Side Effects
- Reflex Tachycardia
- Blood Volume Expansion
- Hypertrichosis
- Pericardial Effusion
- Rash
- Considerations
- Give with Beta Blocker and Diuretic
2 mins
